Department of Pneumology, University Medicine Essen - Ruhrlandklinik, West German Lung Center, University Duisburg-Essen, Duisburg, Germany.
Faculty of Sleep and Telemedicine, University Medicine Essen - Ruhrlandklinik, West German Lung Center, University Duisburg-Essen, Duisburg, Germany.
Sleep Breath. 2024 Mar;28(1):221-230. doi: 10.1007/s11325-023-02887-0. Epub 2023 Aug 5.
Breathing-synchronized hypoglossal nerve stimulation (HNS) is routinely used as an alternative treatment for patients with obstructive sleep apnea (OSA). Significant and clinically relevant improvements in disease severity and OSA symptoms such as daytime sleepiness as well as overall quality of life have been reported in randomized-controlled trials and large real-world cohort studies. However, so far, few data exist on patient-reported experience with the treatment.
A structured survey with 22 questions was constructed using five-level Likert scales (1 = no agreement, 5 = complete agreement) to evaluate patient experience with HNS and perception of the treatment in the domains "Overall experience with therapy," "Experience with treatment process," and "Side-effects from treatment." Additional data were collected on current symptom status, measured with Epworth sleepiness scale (ESS) questionnaire, and OSA disease history. Multiple linear regression analysis was conducted to test associations of medical variables and response behavior. Correlations between variables and domains, as well as individual items, were assessed using Spearman rank test.
A total of 75 patients from Germany who were treated with breathing-synchronized HNS were enrolled (mean age 57.3 years, 78% male), and 71 questionnaires with complete data were included for analysis. Two-thirds of participants (67%) had a history of OSA history for 5 years or longer. Of all patients, 76% had normalized OSA symptoms at time of the study (ESS: 6.4 ± 5.0) and 98% reported using stimulation therapy every night. Regression analysis revealed an association of current symptoms measured with ESS and response behavior. Hence, patients with normalized daytime sleepiness reported significantly more positive experience across all domains assessed, compared to patients with residual daytime sleepiness. Overall, only 2% of participants reported side effects that made them reduce or discontinue stimulation therapy. The rate of reported side effects was associated with current symptom control under therapy.
Overall patient-reported experience with breathing-synchronized HNS therapy was positive and high satisfaction with the treatment process was observed. Side effects occurred, but rarely affected subjective use of the therapy or satisfaction. Subjective experience and perception are influenced by residual daytime sleepiness with stimulation therapy.
呼吸同步舌下神经刺激（HNS）已被常规用于治疗阻塞性睡眠呼吸暂停（OSA）患者的替代疗法。随机对照试验和大型真实世界队列研究报告了疾病严重程度和 OSA 症状（如白天嗜睡）以及整体生活质量的显著且具有临床意义的改善。然而，迄今为止，关于患者对治疗的报告体验的数据很少。
使用五级李克特量表（1 = 不同意，5 = 完全同意）构建了一个包含 22 个问题的结构化调查，以评估 HNS 治疗的患者体验以及在“治疗总体体验”、“治疗过程体验”和“治疗副作用”等领域对治疗的看法。还收集了当前症状状态的额外数据，使用 Epworth 嗜睡量表（ESS）问卷进行测量，以及 OSA 病史。进行多元线性回归分析以测试医学变量和反应行为之间的关联。使用 Spearman 秩检验评估变量和域之间以及单个项目之间的相关性。
共纳入来自德国的 75 名接受呼吸同步 HNS 治疗的患者（平均年龄 57.3 岁，78%为男性），并纳入了 71 份具有完整数据的问卷进行分析。三分之二的参与者（67%）有 5 年或更长时间的 OSA 病史。所有患者中，76%的患者在研究时 OSA 症状正常化（ESS：6.4 ± 5.0），98%的患者报告每晚使用刺激治疗。回归分析显示，当前症状（ESS）与反应行为有关。因此，与白天嗜睡未缓解的患者相比，白天嗜睡正常的患者在所有评估的领域中报告的体验明显更积极。总体而言，只有 2%的参与者报告了副作用，导致他们减少或停止刺激治疗。报告的副作用发生率与治疗下的当前症状控制有关。
患者对呼吸同步 HNS 治疗的总体报告体验是积极的，对治疗过程的满意度很高。发生了副作用，但很少影响主观使用治疗或满意度。主观体验和感知受到刺激治疗下白天嗜睡的影响。
